Welcome to MGPHO

The Medical Gas Professional Healthcare Organization (MGPHO) was founded in 1998 as an organization that is dedicated to advancing the safe design, manufacture, installation, maintenance and inspection/verification of medical gas and vacuum systems through education. The organization is actively involved in identifying, understanding, and maintaining state and federal standards as well as improving the techniques used in testing and verification.

2019 Proposed Bylaw Changes

4.2 Place: The place for the meetings shall be proposed by the Board of Directors a minimum of three (3) months in advance of the meeting and presented for ratification by a two-thirds (2/3) majority of the board members present and entitled to vote.

4.4 Notice of Meeting: A written notice will be provided to the members stating the meeting's place, day, hour, and purpose at least thirty (30) days prior to the meeting date unless otherwise prescribed by the statute.

12.2 Amendments: Every proposed alteration, amendment, or addition to the Bylaws must be submitted to the Organization's office in typewritten form at least one-hundred twenty (120) days prior to the meeting.

The Organization's office shall submit the same to the membership forty-five (45) days prior to the meeting. Any proposed Bylaws change may be amended from the floor for the purpose of clarification or elimination of conflict, if such amendment does not violate the spirit or intent of the proposed Bylaws amendment. Such Bylaws amendments must be approved under the provisions.

At each revision of the Bylaws, the front page shall indicate the date of the last meeting and articles renumbered as required.

Monday, May 06, 2019 7:13 AM |
Anonymous

Question: "Is there a medical indication that the oxygen 99% provision would make a difference in the prognosis of a severely hypoxemic patient in relation to oxygen 93% provision through oxygen generators?"

Dr. Wong's Response: "No, as long as we focus simply on the clinical factors here. However, before we go into the discussion, it is very important that we discuss two terms that are often erroneously used interchangeably. Those terms are hypoxemia and hypoxia. Hypoxia is the actual shortage of oxygen being delivered to the tissues by the blood. Hypoxia causes oxygen starvation of the tissue during cellular respiration. Hypoexemia, on the other hand, is a decrease in the amount of dissolved oxygen in the arterial blood, as measured by the partial pressure of oxygen on arterial blood gas. This distinction is important because the primary carrier or transporter of oxygen to the tissues is the hemoglobin in the red blood cell. This is why blood looks red when exposed to oxygen and air. It is also why a hypoxic patient turns blue.

Because of hemoglobin in the red blood cells, the critically ill patient does not simply rely on a diffusion gradient to oxygenate their blood. Instead, hemoglobin has a high affinity for oxygen and picks up this oxygen across the capillary membranes of the alveoli (air sacks) in the lungs. This is, in effect, what a pulse oximeter measures - the percentage of red blood cells that are oxygenated. This is also the major determinant of hypoxia.

In addition, there is some "left over" oxygen that diffuses via a concentration gradient into the blood plasma. Think of plasma as the fluid that all the blood cells are immersed in. Some of this oxygen gets dissolved in the plasma, exhibiting a partial pressure that can be measured in the lab. The oxygen contributed by this dissolved oxygen is negligible for cellular respiration because it must first dissolve into the plasma across a concentration gradient, and second then diffuse out of the blood plasma into the cells.

Now, if we change our focus toward pulmonary (lung) respiration, we find that the difference between 93% oxygen and 99% oxygen is insignificant for several reasons. First, room air is 21% oxygen. Therefore, there is very little difference in the competitive effect of 93% or 99% comparatively speaking. Secondly, it is very rare to actually deliver oxygen directly, instead it is often given by nasal cannula or mask. Even when oxygen is given, varying amounts are actually received by the patient because of dilution by ambient air or exhalation. For example, a nasal cannula delivers about 24% - 28% inspired oxygen. The closest thing to an exception is the intubated patient (although there still is some dilution via exhalation at the so called T of the breathing circuit). Finally, we each have physiologic dead space, meaning the conductive parts of the airway that are not involved in gas exchange (gases mixing between the alveoli and the blood) such as the nose, mouth, pharynx, larynx, trachea, bronchi. The gas in these dead spaces warm, moisturize, and dilute out the oxygen being delivered.

Therefore, the clinical effect of oxygen 99 vs. oxygen 93 is negligible. Outside the U.S., oxygen 93 is widely used with no clinical issues. The U.S. military has also used and approved oxygen 93. One of the biggest issues even with home concentrators, is the fact that practitioners are not aware that there are differences between the two. However, we don't find an issue with oxygen therapy when practitioners don't adjust their prescription for said therapy when the type of oxygen changes.

Final thought here is that we are becoming much more aware of the oxidative injury that occurs with use of high oxygen concentrations. In the hypoxic patient, we now strive to use the minimal amount of oxygen possible to maintain appropriate oxygenation of the tissues. Perhaps the biggest clinical concern of oxygen 93 from oxygen concentrators is the theoretical concern of concentrating argon and patients receiving higher than normal amounts of argon gas."

2018 Board of Directors Election Results

MGPHO is pleased to announce the election of its new President, Kyle Jussel. Kyle is the president of Medical Air Testing & Service, Inc. in Lakewood, Colorado.

Kyle holds significant experience and recognized leadership within the industry. Please join us in welcoming him in his new position.

ASSE 6035 Program Discontinued

The MGPHO ASSE 6035 Bulk Medical Gas Systems Verifiers program has been discontinued. Renewals will not be accepted after December 31, 2017. The following organizations, listed in alphabetical order, have expressed an interest in providing the ASSE 6035 credential and can assist our cardholders in renewing their credential:

If you have questions or need additional information, please contact Al Moon.

The Clinical Importance of Appropriately Designed Medical Gas Systems for Dental Offices

Be sure to read the June 2018 issue of The Anesthesia Patient Safety Foundation newsletter (pages 17 - 19) for the article titled "Safe Gas Systems and Office-Based Anesthesia" written by Jonathan L. Wong, DMD and Gerhard Gschwandtner, PEng. This article explains why dental offices are not exempt from following NFPA 99, and why routine maintenance/certification of office-based gas systems is recommended.

Dr. Wong presented "The Rise of Sedation and General Anesthesia in the Dental Office and the Clinical Importance of Appropriately Designed Gas Systems" at our annual conference this year in Atlanta, Georgia.

Not a member? Join today!

Our membership includes professional technicians, manufacturers, equipment suppliers, medical professionals and others interested in maintaining the integrity of medical gas systems. Membership in the organization will ensure that you are up-to-date on the latest changes in standards and verification practices.

Exhibitor Information

If you are a corporate member of the organization and your 2019 dues have been paid, then you are entitled to exhibit at the meeting for no additional cost. To register, click on the link above and choose the "Prepaid Exhibitor" option.

Booths will be chosen on site on a first-come, first-served basis in the Mesquite room. Electrical outlets are available around the room, but extension cords may be necessary. If you have any special or unique requirements, please contact the event manager.

Location: Flamingo Las Vegas, Mesquite

Exhibit Date: Tuesday, October 1, 2019

Exhibit Time: 5:00 p.m. - 8:00 p.m.

Booth Set-Up: Monday, September 30th from 8:00 a.m. to 8:00 p.m. and Tuesday, October 1st from 8:00 a.m. to 3:00 p.m.

Click here for more information about shipping exhibit materials and supplies.

Corporate Sponsors

MGPHO Apparel

Do you want your own MGPHO shirts, hats or other apparel? You can place your order here!

Meet Our Special Expert

Jim Lucas

V.P., Sales & Marketing

Tri-Tech Medical, Inc.

"Why am I a Special Expert for MGPHO? I’m not really sure, I think I’m ‘just one of the guys’. I believe that at one point in the day each of us has a moment of genius and at another point each of us has a moment of oops. To answer your question, probably my knowledge of manifolds, regulators, alarms and fittings are my greatest strengths and perhaps the reason that MGPHO bestowed me with this honor."